There is now a pause in the inept debate on health care in Congress. After a year of struggle, some comfort might be taken from the fact that neither of the monstrosities passed by the House or the Senate has become law.

However, truer than ever is the 200-year-old adage that "no man's life, liberty or property is safe while the legislature is in session." The change of one Senate seat is not a solid foundation to protect us from the threat of massive government intrusion in American medicine. And President Obama's State of the Union message is an indication that all of the worst features of last year's House and Senate bills are likely to come roaring back.

If the best defense is a good offense, real reforms should be put forward now that permit better and more affordable health care and that expand, rather than restrict, personal choice and freedom.

Those who told us government must control health care in order to eliminate large-scale inefficiency and fraud should be expected to immediately pass legislation to end such waste and fraud in Medicare. Further expansion of government management of medicine should hardly be a precondition for correcting the expensive mess we already have today.

Although state regulations and federal tax policy are responsible for prohibiting real competition in health insurance, we are told that government-run insurance is the only way to provide competition. To forestall such nonsense in the future, we should immediately enforce the interstate commerce clause of the U.S. Constitution to allow insurance to be sold on a national basis, across state lines. Such real competition would lower the cost of insurance for most Americans.

Limits on non-economic damages in medical liability cases would decrease the cost of insurance and the unnecessary tests and procedures now required by defensive medicine.

Each of these proposals can be enacted as separate and simple legislative acts without any special deals or pay-offs to the clients of members of Congress.

As each proposal from the House and Senate bills raises its head again, it should be held to a few simple tests:

1. No new government boards, agencies or commissions.
2. No new government spending.
3. No new taxes, fees or fines.
4. No criminal punishment for choosing not to buy insurance.
5. No new federal employees.
6. No special deals, pay-offs or exclusions for anyone. We must require the same deal for all citizens, whether they have political pull or not.

The best way to evaluate reform proposals is to first determine the direction in which they would take us. More government spending or less? More taxes or fewer? More government agencies or fewer? More freedom and choices for individuals, or more obedience to rules, regulations and mandates? More decisions by physicians to best meet the unique condition of each patient, or more government enforcement of "protocols" that physicians must apply to all patients? Privacy for the doctor-patient relationship, or the turning over of all personal medical records to the government so it can monitor and supervise doctors' decisions?

Consistency is as important in evaluating reform proposals as direction. We should never accept proposed legislation that expands freedom in one aspect of health care while imposing controls and restrictions in others.

Also important is tone. Do the proposals reflect contempt for medical providers? Do they reflect contempt for drug companies, insurance companies and manufacturers due to an underlying agenda of contempt for all profitable business activity? Do they revere dependence on government as an end in itself?